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Cited by 16Tuberculosis Research and EpidemiologyInfectious Diseases and TuberculosisDiagnosis and treatment of tuberculosis

The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.

Does Drug-Resistant Extrapulmonary Tuberculosis Hinder TB Elimination Plans? A Case from Delhi, India

Open access
Lohiya, Sheelu, Tripathy, Jaya Prasad, Sagili, Karuna, Khanna, Vishal, Kumar, Ravinder, Ojha, Arun, Bhatnagar, Anuj, Khanna, Ashwani·2020·Tropical Medicine and Infectious Disease
DOI 10.3390/tropicalmed5030109PMC PMC7558170
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Abstract

Extrapulmonary drug-resistant tuberculosis (DR-EPTB) poses a formidable diagnostic and therapeutic challenge.Besides associated with high morbidity, it is a major financial burden for the patient and the health system. In spite of this, it has often been neglected as it does not “pose” a visible public health threat. We study clinical profiles, treatment outcomes, and factors associated with unfavourable outcomes among DR-EPTB patients under programmatic settings in New Delhi, India, and evaluate how this could impact TB elimination. A retrospective analysis of all DR-EPTB patients registered at three nodal DR-TB centres in Delhi in 2016 was carried out. Of the 1261 DR-TB patients registered, 203 (16%) were DR-EPTB, with lymph nodes (118, 58%) being the most common site, followed by bone (69, 34%). Nearly 29% (n = 58) experienced adverse drug reactions with severe vomiting (26, 13 %), joint pain (21, 10%) and behavioral disorder (15, 7%). History of previous TB treatment was observed in a majority of the cases (87.7%). Nearly one-third of DR-EPTB cases (33%) had unfavourable treatment outcomes, with loss-to-follow-up (n = 40, 58%) or death (n = 14, 20%) being the most common unfavourable outcomes. In the adjusted analysis, weight band 31–50 kilograms (aRR = 1.8, 1.2–3.4) and h/o previous TB (aRR = 2.1, 1.1–4.8) were mainly associated with unfavourable outcomes. TB elimination efforts need to focus on all forms of TB, including DR-EPTB, leaving no one behind, in order to realise the dream of ending TB.

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  • The rate of rifampicin resistance among epTB cases in this study (4.83%) was lower than rates reported in previous Indian studies by Kant et al. (13.4%), Lohiya et al. (16%), and Misra et al. (2021).

    “the study found that the rate of rifampicin resistance among epTB cases was 4.83%, which is lower than the rate reported by previous studies conducted in India by Kant et al.,2018 (13.4%)15, Lohiya et al. 2020 (16%)16, and Misra et al. in 202117.”

    From Prevalence of extrapulmonary tuberculosis and factors influencing successful treatment outcomes among notified cases in South India (2025) · cites this paper as [16]

    The Results (§4.1) and Discussion (§5) say that 203 of 1,261 registered drug-resistant TB patients (16%) had extrapulmonary TB. The citing sentence reverses the denominator: 16% is not the rate of rifampicin resistance among extrapulmonary TB cases. (LLM, conf=0.91)

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Metadata

Authors
Lohiya, S., Tripathy, J. P., Sagili, K., Khanna, V., Kumar, R., Ojha, A., Bhatnagar, A., & Khanna, A.
Affiliations
  • Lok Nayak Jai Prakash Narayan Hospital (IN)
  • All India Institute of Medical Sciences, Nagpur (IN)
  • International Union Against Tuberculosis and Lung Disease (US)
  • All India Institute of Medical Sciences (IN)
  • Rajan Babu Institute of Pulmonary Medicine and Tuberculosis, New Delhi 110009 India
Corresponding author
Lohiya, Sheelu
ORCID
Venue
Tropical Medicine and Infectious Disease
Publisher
MDPI AG
Published
2020-07-01
Volume
5
Issue
3
Pages
109
ISSN
2414-6366 (ISSN-L)
DOI
10.3390/tropicalmed5030109
PMC
PMC7558170
OpenAlex
W3040405981
Cited by
16
References
18
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 6 · 2020: 1
FWCI
0.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Tropical Medicine and Infectious Disease (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Global Fund to Fight AIDS, Tuberculosis and Malaria
  • World Health Organization
  • Postgraduate Institute of Medical Education and Research, Chandigarh
  • Ministry of Health and Family Welfare
Topics
  • Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
  • Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
  • Health Sciences › Medicine › Infectious Diseases › Diagnosis and treatment of tuberculosis
Keywords
drug-resistant tuberculosis, extrapulmonary tuberculosis, tuberculous lymphadenitis, bone tuberculosis, adverse drug reactions, treatment outcomes, loss to follow-up, tuberculosis elimination, previous TB treatment, body weight, New Delhi

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